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/ SrAN JO'2UiN COUNTYPUBLIC HEALTH SE' 1'ICES <br /> 1,�JIRONMENTAL HEALTH DIVISION% <br /> yp l 304 EAST WEBER AVENUE,THIRD FLOOR _ <br /> STOCKTON CA 95202 <br /> I(� (209)468.3420 <br /> ' PUBLIC RECORDS RELEASE APPLICATION ��---- <br /> APPUCANT BU51NESWAGENCY Q� 00N p-W&LII!'dAit1 E 0 !ZfC <br /> ADDRESS 937 r0 .1� S�i7C,�Il r � :/J 9'S� y. 1 �y <br /> PHONE � 7 yh /ry -1611kFACSIMILE A2W 9- �� ! - /�d ll� .� —IJ' <br /> TENTATIVE'APPOINTMENT DATE TIME MAY 9 5, ?nnl <br /> (Please give T to 10 business clays ftGnl dale 0f aPPlication Zowauq <br /> HEATH <br /> 4qCHECKBOx TOE)(PrgrrEREQUEST- T . 0 E— QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE Ill Z� goo( <br /> A , LUUjO <br /> lLzi.l6t /Cis *Iffl <br /> y <br /> t L N <br /> XIAno /L� .2 ¢i 290/, 9d-0 Z te 2 <br /> LZ' ZZZla 23` <br /> S L.cCiY ,4MaM <br /> ICo/ MELEE, <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> (UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY JUN - 1 2001 <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORIRGIREMOVAL) ❑ BOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUNOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑ TATtooisODY PEIRCING ❑ POOLISPA 4 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 4 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. list up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (2091464-0138 or mail to the <br /> address indicated above. <br /> 2_ EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10) days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant Future fiie reviews by the same applicant may require a$78.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3-00 pm will be processed the next business day_ <br /> CONI FIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> 01 MIA OfNIAo <br />